Individual provider Active NPI

Laura Beatrice Kavesh, PHD

  • Clinical Psychologist
  • Portland, ME
National Provider Identifier
1144230699
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS1105 Issued in ME
Practice address
216 Vaughan St
Portland, ME 04102-3204
Phone
(207) 662-2221
Fax
(207) 662-6348
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS1105 ME Primary

Addresses

Primary practice location

216 Vaughan St
Portland, ME 04102-3204

Mailing address

216 Vaughan St
Portland, ME 04102-3204
Phone (207) 662-2221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050105000560 ME Practitioner - Clinical Psychologist 6608824784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS1105MEMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Feb 15, 2020 Accepting new patients
Mainehealth CurrentSince Feb 15, 2020 Accepting new patients
Mainehealth Current Accepting new patients

Locations

66 Bramhall St
Portland, ME 04102
Phone (207) 662-3157

216 Vaughan St
Portland, ME 04102
Phone (207) 662-2221

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

123 Andover Rd
Westbrook, ME 04092
Phone (207) 761-2200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1144230699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 VAUGHAN ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023204",
            "telephone_number": "207-662-2221",
            "fax_number": "207-662-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 VAUGHAN ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023204",
            "telephone_number": "207-662-2221",
            "fax_number": "207-662-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVESH",
        "first_name": "LAURA",
        "middle_name": "BEATRICE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS1105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.